Vulnerable Persons: Care Interventions and Safeguarding Legislation

This report reviews the care interventions of Making Safeguarding Personal and Advocacy for vulnerable persons, and their relation to safeguarding legislation. It discusses the importance of safeguarding adults and the changes in legislation over time. The interventions aim to protect vulnerable adults and empower them in decision-making.

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Assignment
Title: Vulnerable Persons
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Anglia Ruskin University

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Introduction
A vulnerable person or adult may be defined as someone who is unable to protect himself from
the harm, and is unable to care for himself due to illness, age or other reasons (Department of
Social Services, 2014). The report reviews the two care interventions: Making Safeguarding
Personal and Advocacy, which may be applied to the case study of George. The work also
illustrates the knowledge of relevant safeguarding legislations.
Safeguarding
Safeguarding the Adults refers to the process of protecting the rights of a person to live in a safe
environment free from neglect and abuse. As per the recommendations of the Care Act 2014, the
local Authorities should enquire in case they feel that an adult is being abused or neglected. The
enquiry may confirm whether the person needs immediate action to be taken or not. It also
directs who will be the care provider. It may require setting up of a safeguarding board and
arrangements of independent advocates in assisting the adult at risk. It requires cooperating with
all the care providers to protect the adult. Safeguarding ensures protection of adults to reduce
their risk of abuse and prevent harm. The adults are provided with adequate control of their life
letting them choose the extent of interference by the care providers.
The Change
In 2012, ‘A guide for safeguarding children and vulnerable adults in General Practice’ was
published for the first time. Since then, the legislation has encountered several changes in the
safeguarding practice. The intervention was first used to ‘safeguard the children’ where only few
parts of the legislation involved adult protection. However, now it has transformed to safeguard
the people of all the age groups. The Social Service and Well Being Act (2014), came in effect in
2016 with many changes adding the adults into the legislation (Farr, Davies and Blackstock,
2016). Local Safeguarding Boards also got transformed into Regional and National Safeguarding
Boards. Now Adult Safeguarding has become an essential priority. It has become a duty for these
Boards to report about the adults who are at risk of being vulnerable.

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An adult ‘at risk’ may be a person who is more than 18 years of age; and who may not be
capable of protecting himself from the abuse and exploitation. He may be the one who is in need
of the care services due to illness, disability, mental retardation, or age related issues
(Department of Social Services, 2014).
First Intervention- Making Safeguarding Personal
The approach of making safeguarding personal refers to a personalized way of safeguarding
‘with’ the people, helping the people in achieving the improvements in their lives, utilizing their
social work skills and acknowledging the difference made in their lives. The people suffering
from dementia may be highly vulnerable (Social Care Institute for Excellence [SCIE], 2019).
Their early symptoms may adversely affect the reasoning ability and communication.
Safeguarding for a dementia person may involve treating him with dignity, protecting him from
the abuse of outside community and maintaining his human rights (Badenoch, 2016). The
approach should be more people centered. Instead of focusing on psychotic activities in process,
we should focus on his needs to keep him safe from harm and to manage risk in his life.
Relation to the Legislation
According to safeguarding legislation, the care providers, the organizations and adult
safeguarding boards are given certain priorities and responsibilities under the Care and Support
Statutory Guidance 2017. Relevant laws in this regard are Mental Capacity Act (2005), Human
Rights Act (1998) and Care Act (2014) (Dementia Advocacy and Support Network [DASN],
2015). This care intervention involves the initiatives necessary to develop Sustainability and
Transformation Plans (STPs) and Accountable Care Systems (ACSs). The theme includes
commissioners and providers collaborating to facilitate best practices, a holistic emphasis on
safety, health and well being, and multiple sectors working together to deliver safe health
services (Department of Health and Human Services [DHHS], 2018). The effectiveness of the
intervention is evaluated by Care Quality Commission (CQC) and asserted by assessment of
safety, responsiveness, being well-led, effectiveness and care (Association of Directors of Adult
Social Services [ADASS], 2018).
Second Intervention- Advocacy

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The intervention of advocacy may support the people in making tough decisions and respecting
their wishes and rights (Warwickshire Safeguarding Adults Boards, 2017). The independent
Advocacy Organizations provide a professional advocate who may enquire with the patient, can
listen to him, can represent the interests and views of the person when he is dealing with other
support agencies.
The Advocacy may focus on positive and strength based activities, to promote the things Adults
can do instead of what they can’t. It will empower them.
Association with Legislation
The Care Act Advocacy provides the power to the adult at risk to provide the Advocacy workers
as much control of their lives as they want. It assists the workers in understanding the person at
risk and helps them speak out what they need. For availing the entitlement to this Care Act, the
two underlying situations are: (1) The adult at risk does not have anyone to speak from his point
of view, and to support him. (2) The adult at risk has problems in getting involved in the care,
assessment and safeguarding. The adult may have problem in understanding or remembering the
information, and taking effective decisions. The person may be referred to an Advocate for the
subsequent process of care and support.
Application of First Intervention
During the early stage of dementia, George may exhibit symptoms like memory issues, increased
level of confusion, deteriorated concentration, behavioral and personality changes, language
problems, disorientation, depression, apathy and inability in doing everyday tasks.
The staff in the care home can have conversation with George about how they can respond to the
situation to improve his quality of life. The care providers need to consider George as the expert
of his own life and working with him. It may take a number of conversations with George
supported by the empowerment process. We need to understand the George’s perspective,
negotiating, agreeing and recording the desired outcomes of the patient. According to Mental
Capacity Act 2005, we should not make assumptions about his lack of capacity but support him

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in making decision with his beliefs and values (Local Government Association, 2015). We can
consult with his family members as well regarding his decision of not going back home.
George can be provided awareness about his health issue that is dementia and his problem of
forgetting things. He should be provided adequate training to be on his own. However, the
involvement of the care providers should be only as much as he wants.
Speaking for himself may be encouraged for George, as he can communicate well and tell about
his preferences. IT will improve his assertion and confidence level. He may also be provided
issue based advocacy or non instructed advocacy to resolve the situation where George is feeling
difficult to take decision. Such advocacy may be provided by specialist advocates and
professionals provided by the Organisations for Advocacy. It will help George in reviewing the
available options, take decisions about the outcomes and take part in decision making.
The Care home should have arrangements for providing him training about how to be safe, using
the electronic gadgets about seeking directions, walking appropriately and doing his daily tasks
on his own. He can be provided skill development opportunities and connecting with the
community services where he can enjoy with the people of similar age and interest.
During enquiry he may be asked open ended questions to facilitate more discussion and
information sharing. It will remove depressive symptoms from his mind. George may also be
provided daily visiting social care services to visit his home and help him in his care.
The Care Act 2014 also involves assessment of the home conditions and the skin integrity of the
other family members about taking care for George. The care workers may also assess his
nutrition state which is found to be inconsistent. The safety of George will be assessed during the
discharge and if the board finds that it is not safe to send him home, as per his preferences, he
will be kept at the Care Home or may be referred to the Adult Social Care. The General
Practitioners and the Nurse will also be informed to assess his medical condition on regular
basis.
Drawbacks with Making Safeguarding Personal

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As George is not able to decide whether he wants to stay in the care home or he wants to go to
his home, it may create a dilemma for the care providers. The patient having Dementia may be
not capable enough to provide stabilized opinion about what he wants to do (Armytage, 2016). It
may result into consistent change in statements and mood, as he is also suffering from depression
and isolation tendency. George may need a regular Advocacy worker to visit him regularly at
home to care for him.
Application of Second Intervention
The intervention of Advocacy must ensure that the interests of George are considered into
account during the process of care providing. George does not want to go back to his home as his
family members do not listen to him. This concern should be addressed by communicating with
the family members. The family can be informed to provide him appropriate home environment
so that he could return back, as George does not like to stay in the care home as well.
Communicating with George for longer durations will develop trust in relationship. The
Advocacy worker may act as a bridge in closing the gap in the family and in communicating the
patient’s perspective to the family (Dementia Services Development Center [DSDC], 2013)
The situation may be assessed for any need of emergency services and the safety and well being
of George need to be maintained. The evidences must be maintained about the condition of the
patient (George) in form of medical documentation and state of health. The care providers need
to maintain calm during assessment and must try to communicate with him, listen to him,
following the procedures to report the incident to the local police. A documented record of the
information collected during the communication with person and his family should be
maintained (Cortes, 2016). To facilitate his empowerment the informed consent and person led
decisions should also be maintained.
Drawbacks with Advocacy
The availability of a professional Advocate may be restricted by the financial constraints of the
family (Advocacy for All, 2013). George may not be capable of giving accurate and directed
responses which could lead towards faster outcome. He may take time to communicate. All this

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will require a specialist Advocate to speak from his side and communicate with all the
stakeholders involved.
Also, It may be not possible to involve the professionals immediately due to their other busy
work schedules. The intervention involves a longer commitment from the staff and the
professionals require a paternalistic approach to deal with the people of Dementia like George.
Comparison
The two interventions discussed for George will undoubtedly facilitate a person centered care
based on his own preferences and priorities. By making the safeguarding personal, the care can
be customized according to the changing healthcare needs and other social care requirements of
the person at risk (Hole, 2018). George needs a comprehensive personal care with the
involvement of General Practitioner and Nurses to assess his health and other related factors. He
needs the care of Advocacy workers to communicate his arguments and choices to the family
members and bring out an appropriate conclusion out of the collected information.
Being in depression and in a biased state of mind, Advocacy will help in making decisions in his
best interest and favor. Advocacy will also help in reaching a common decision after the
implementation of intervention (Lee, 2016). The Advocacy worker may continue to visit George
regularly to ensure his welfare and to continue speaking out his views.
Conclusion
George being in his early state of dementia, requires professional community care which could
provide him medical aid, training for walking, maintaining poise and remembering things. The
two interventions of making the Safeguarding personal and Advocacy will protect him from the
vulnerable condition where he is not in a condition to take care of himself. He will be given
timely food, and treatment for depression. His family may be informed about his missing while
going out to a shop. His preference of not going back to home will be voiced by the Advocacy
worker or the Advocate. The information collected by discussing the scenario with the family

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members and after assessment of George’s preferences and state of health, he may be sent to his
home. The Care worker may be visiting to see George at home to assess his improvements in his
health and identify additional support in case he needs it.

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References
Advocacy for All (2013). Introduction to the Care Act 2014. Retrieved from
http://www.advocacyforall.org.uk/careact.php
Armytage, B.(2016). Specialist Advocacy Services in Aged Care for people with dementia.
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aged-care-for-people-with-dementia
Association of Directors of Adult Social Services [ADASS], (2018). Making Safeguarding
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%20CHIP%20Making%20Safeguarding%20Personal%3B%20What%20might
%20%E2%80%98good%E2%80%99%20look%20like%20f.-2.pdf
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personal-are-we-there-yet/
Cortes, A.C. (2018). Advocating for your patients with Dementia. Retrieved from
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from https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/dementia-early-signs
Department of Social Services (2014). Vulnerable Persons, Police Checks and Criminal
Offences. Retrieved from https://www.dss.gov.au/about-the-department/doing-business-with-
dss/vulnerable-persons-police-checks-and-criminal-offences
Dementia Services Development Center [DSDC],(2013). Dementia Centered. Retrieved from
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%20guide%20for%20Safeguarding%20Children%20and%20Adults%20at%20Risk%20in
%20General%20Practice%20September%202016%202.pdf
Hole, E. (2018). Building a Staff and Resident Partnership around Dementia By Elizabeth Hole.
Retrieved from https://daanow.org/4293-2/

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Lee,E.(2018). Independent Advocacy for People Living with Dementia and Unpaid Carers.
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%20Advocay%20and%20Dementia%20Report.pdf
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